Sitting in a cozy office waiting for clients is not how Rabeeha Ghaffar sees her job at the Western Colorado AIDS Project.

“I don’t wait for them to come to me, because that is not going to happen most of the time,” said Ghaffar, the prevention resource director for WestCAP.

She seeks out clients at homeless shelters, at alcohol and drug recovery programs and at Mesa County’s Summit View meth rehabilitation center. In the last 2 1/2 years she has tested nearly 200 people in 22 counties across Western Colorado, because, she said, “It wasn’t getting done.”

Ghaffar is not looking for new infections of HIV, the virus that causes AIDS. She is seeking out a far more elusive virus: hepatitis C.

The results of Ghaffar’s aggressive testing, funded by the Colorado Department of Public Health and Environment at $40 a test, has given her cause for concern. This fiscal year she has tested 103 people, compared to 35 last fiscal year. Despite the increase in testing she is maintaining an average 12 percent positive rate for hepatitis C among the at-risk population she goes looking for — injection drug users — and the HIV-positive clients who access WestCAP’s services.

“Which is, according to the state health department, the highest in the state,” she said. “Usually when you increase the tests the positivity rate goes down, so that is telling me that it is a very alarming concern.”

While WestCAP’s focus is HIV and AIDS, its staff started to notice 10 percent of its clients also had hepatitis C. So in 2005 it contacted the state health department for assistance to become a designated testing center along with the Mesa County Health Department.

A study of injection drug users in Denver found that 75 percent of those tested for hepatitis C tested positive, according to the health department. Ghaffar said in Mesa County, 95 percent of those who test positive are injection drug users.

The virus is able to survive outside the body for four days. In a needle the virus can survive for up to six months, she said. The test, drawing of blood from a pin prick to one finger, takes two weeks to get results. If left untreated, hepatitis C can cause death.

“There is no cure,” Ghaffar said. But with detection there are ways to manage the disease and prevent its spread, she said.

The places Ghaffar can send people for treatment who test positive are limited: The Marillac Clinic; St. Mary’s Hospital; or a private physician.

“Try finding an expert,” she says with some exasperation. “I mean that is super-expensive.”

Ghaffar’s findings should not be misconstrued and applied to the entire county.

Because WestCAP tests only those at highest risk of infection, “the positivity rate at the WestCAP testing site cannot be generalized to all of Mesa County,” according to an e-mail to
The Daily Sentinel from Amy Warner, viral hepatitis program manager for the state health department. “The numbers are so small, that we can’t say that changes in rates from year to year accurately reflects true changes within the rates of hepatitis C infection in any county.”